scholarly journals Dutch retirement migration to Spain and Turkey: Seeking access to healthcare across borders

2016 ◽  
Vol 6 (3) ◽  
pp. 326-343 ◽  
Author(s):  
Anoeshka Gehring
Keyword(s):  
Access To Healthcare ◽  
Retirement Migration

Common Enemies

2019 ◽  
Author(s):  
Rachel Kahn Best
Keyword(s):  
Medical Research ◽  
Well Being ◽  
Access To Healthcare ◽  
Health Policies ◽  
Awareness Campaigns ◽  
Comprehensive Data ◽  
Time Changes ◽  
Perception Of Health ◽  
Individual Disease ◽  
Improve Health

Americans come together to fight diseases. For over 100 years, they have asked their neighbors to contribute to disease campaigns and supported health policies that target one disease at a time. Common Enemies asks why disease campaigns are the battles Americans can agree to fight, why some diseases attract more attention than others, and how fighting one disease at a time changes how Americans distribute charitable dollars, prioritize policies, and promote health. Drawing on the first comprehensive data on thousands of organizations targeting hundreds of diseases over decades, the author shows that disease campaigns proliferate due to the perception of health as a universal goal, the appeal of narrowly targeted campaigns, and the strategic avoidance of controversy. They funnel vast sums of money and attention to a few favored diseases, and they prioritize awareness campaigns and medical research over preventing disease and ensuring access to healthcare. It’s easy to imagine more efficient ways to promote collective well-being. Yet the same forces that limit the potential of individual disease campaigns to improve health also stimulate the vast outpouring of money and attention. Rather than displacing attention to other problems, disease campaigns build up the capacity to address them.

Access to Healthcare in Europe

2020 ◽  
Author(s):  
André den Exter ◽  
Keith Syrett
Keyword(s):  
Health Services ◽  
Healthcare Systems ◽  
Access To Healthcare ◽  
Regulatory Framework ◽  
European Healthcare ◽  
Key Characteristics ◽  
To Receive ◽  
Delivery Of Health Services

This chapter describes the main features of European healthcare systems. The chapter identifies key characteristics of these systems: the organisation, financing, and delivery of health services, and the main actors. It then questions what the systems cover, who are eligible to receive healthcare, when patients receive healthcare, and the physician’s duty to provide care. In addition to highlighting the applicable regulatory framework, this chapter also describes some general trends.

scholarly journals Access to healthcare and self-rated health among refugees in transit and after arrival in Norway

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Haj-Younes ◽  
E Strømme ◽  
W Hasha ◽  
J Igland ◽  
E Abildsnes ◽  
...  
Keyword(s):  
Health Care ◽  
Host Country ◽  
Access To Health Care ◽  
Negative Impact ◽  
Minority Group ◽  
Access To Healthcare ◽  
Syrian Refugees ◽  
Self Rated Health ◽  
Perceived Access ◽  
In Transit

Abstract Background Lack of basic infrastructure and poor provision of health services in conflict settings and during flight can have a negative impact on health. The overall health status of refugees seems to improve after arrival at a safe destination. This may be related to a safer environment and better access to health care services, but prior studies on this topic are limited. This study aims to assess self-perceived access to healthcare and its relationship with self-rated health (SRH) among refugees in transit and when settled in a host country. Methods We used data from the CHART study (Changing Health and health care needs Along the Syrian Refugees' Trajectories to Norway), which includes a cohort of 353 Syrian refugees who were contacted in 2017-2018 in Lebanon while waiting for relocation, and one year after their arrival to Norway. Information on self-perceived access to healthcare and its association with SRH was analyzed separately at each time-point. Data analysis was performed with STATA using logistic regression adjusting for age, gender, ethnicity and years of education and presented as adjusted odds ratios (AOR) with 95% CI. Results Fifteen percent reported good access to healthcare and 62% reported good SRH in Lebanon vs. 91% and 77% respectively, in Norway. Measures in Lebanon showed no association between access to healthcare and good SRH (AOR: 1.2 (0.6-2.2)), and men reported worse access to healthcare than women (AOR: 0.5 (0.3-1.0). In Norway, access to healthcare was strongly associated with good SRH (AOR: 4.7 (2.1-10.7) and was negatively associated with belonging to one specific minority group (AOR: 0.1 (0.0-0.3)). Conclusions Both SRH and perceived access to care improved from being in transit to being settled in Norway, the latter substantially more. There was a significant association between access to healthcare and good SRH after the refugees' arrival to a safe host country but not in transit. Key messages Refugee’s self-reported health and access to healthcare seem to improve shortly after arrival to a host country. To ensure that the UN’S Sustainable Development Goals concerning health equity are reached, refugees’ access to healthcare in transit and its impact on overall health needs to be addressed.

scholarly journals Contexts and mechanisms that promote access to healthcare for populations experiencing homelessness: a realist review

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043091
Author(s):  
Rikke Siersbaek ◽  
John Alexander Ford ◽  
Sara Burke ◽  
Clíona Ní Cheallaigh ◽  
Steve Thomas
Keyword(s):  
Health System ◽  
Healthcare Access ◽  
Grey Literature ◽  
Realist Review ◽  
Access To Healthcare ◽  
Staff Retention ◽  
Programme Theory ◽  
Eligibility Criteria ◽  
Ovid Medline ◽  
High Level

ObjectiveThe objective of this study was to identify and understand the health system contexts and mechanisms that allow for homeless populations to access appropriate healthcare when needed.DesignA realist review.Data sourcesOvid MEDLINE, embase.com, CINAHL, ASSIA and grey literature until April 2019.Eligibility criteria for selecting studiesThe purpose of the review was to identify health system patterns which enable access to healthcare for people who experience homelessness. Peer-reviewed articles were identified through a systematic search, grey literature search, citation tracking and expert recommendations. Studies meeting the inclusion criteria were assessed for rigour and relevance and coded to identify data relating to contexts, mechanisms and/or outcomes.AnalysisInductive and deductive coding was used to generate context–mechanism–outcome configurations, which were refined and then used to build several iterations of the overarching programme theory.ResultsSystematic searching identified 330 review articles, of which 24 were included. An additional 11 grey literature and primary sources were identified through citation tracking and expert recommendation. Additional purposive searching of grey literature yielded 50 records, of which 12 were included, for a total of 47 included sources. The analysis found that healthcare access for populations experiencing homelessness is improved when services are coordinated and delivered in a way that is organised around the person with a high degree of flexibility and a culture that rejects stigma, generating trusting relationships between patients and staff/practitioners. Health systems should provide long-term, dependable funding for services to ensure sustainability and staff retention.ConclusionsWith homelessness on the rise internationally, healthcare systems should focus on high-level factors such as funding stability, building inclusive cultures and setting goals which encourage and support staff to provide flexible, timely and connected services to improve access.

scholarly journals Peer advocacy and access to healthcare for people who are homeless in London, UK: a mixed method impact, economic and process evaluation protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050717
Author(s):  
Sujit D Rathod ◽  
Andrew Guise ◽  
PJ Annand ◽  
Paniz Hosseini ◽  
Elizabeth Williamson ◽  
...  
Keyword(s):  
Lived Experience ◽  
Ethics Committee ◽  
Access To Healthcare ◽  
London School ◽  
Journal Articles ◽  
Mixed Methods Evaluation ◽  
Evaluation Protocol ◽  
Study Progress ◽  
Conference Presentations ◽  
Study Designs

IntroductionPeople who are homeless experience higher morbidity and mortality than the general population. These outcomes are exacerbated by inequitable access to healthcare. Emerging evidence suggests a role for peer advocates—that is, trained volunteers with lived experience—to support people who are homeless to access healthcare.Methods and analysisWe plan to conduct a mixed methods evaluation to assess the effects (qualitative, cohort and economic studies); processes and contexts (qualitative study); fidelity; and acceptability and reach (process study) of Peer Advocacy on people who are homeless and on peers themselves in London, UK. People with lived experience of homelessness are partners in the design, execution, analysis and dissemination of the evaluation.Ethics and disseminationEthics approval for all study designs has been granted by the National Health Service London—Dulwich Research Ethics Committee (UK) and the London School of Hygiene and Tropical Medicine’s Ethics Committee (UK). We plan to disseminate study progress and outputs via a website, conference presentations, community meetings and peer-reviewed journal articles.

scholarly journals Telemammography for breast cancer screening: a cost-effective approach in Argentina

2021 ◽  
Vol 28 (1) ◽  
pp. e100351
Author(s):  
Victoria Alba Malek Pascha ◽  
Li Sun ◽  
Ramiro Gilardino ◽  
Rosa Legood
Keyword(s):  
Breast Cancer ◽  
Sensitivity Analysis ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Probabilistic Sensitivity Analysis ◽  
Mammography Screening ◽  
Cost Effective ◽  
Access To Healthcare ◽  
Over 40 Years ◽  
Improve Access

ObjectivesArgentina is a low and middle-income country (LMIC) with a highly fragmented healthcare system that conflicts with access to healthcare stated by the country’s Universal Health Coverage plan. A tele-mammography network could improve access to breast cancer screening decreasing its mortality. This research aims to conduct an economic evaluation of the implementation of a tele-mammography program to improve access to healthcare.MethodsA cost-utility analysis was performed to explore the incremental benefit of annual tele-mammography screening for at-risk Argentinian women over 40 years old. A Markov model was developed to simulate annual mammography or tele-mammography screening in two hypothetical population-based cohorts of asymptomatic women. Parameter uncertainty was evaluated through deterministic and probabilistic sensitivity analysis. Model structure uncertainty was also explored to test the robustness of the results.ResultsIt was estimated that 31 out of 100 new cases of breast cancer would be detected by mammography and 39/100 by tele-mammography. The model returned an incremental cost-effectiveness ratio (ICER) of £26 051/quality-adjusted life-year (QALY) which is lower than the WHO-recommended threshold of £26 288/QALY for Argentina. Deterministic sensitivity analysis showed the ICER is most sensitive to the uptake and sensitivity of the screening tests. Probabilistic sensitivity analysis showed tele-mammography is cost-effective in 59% of simulations.DiscussionTele-mammography should be considered for adoption as it could improve access to expertise in underserved areas where adherence to screening protocols is poor. Disaggregated data by province is needed for a better- informed policy decision. Telemedicine could also be beneficial in ensuring the continuity of care when health systems are under stress like in the current COVID-19 pandemic.ConclusionThere is a 59% chance that tele-mammography is cost-effective compared to mammography for at-risk Argentinian women over 40- years old, and should be adopted to improve access to healthcare in underserved areas of the country.

scholarly journals Mortality beyond emergency threshold in a silent crisis– results from a population-based mortality survey in Ouaka prefecture, Central African Republic, 2020

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Eve Robinson ◽  
Lawrence Lee ◽  
Leslie F. Roberts ◽  
Aurelie Poelhekke ◽  
Xavier Charles ◽  
...  
Keyword(s):  
Central African Republic ◽  
Causes Of Death ◽  
Maternal Mortality Ratio ◽  
Mortality Rates ◽  
Population Based ◽  
Access To Healthcare ◽  
Mortality Data ◽  
Humanitarian Emergency ◽  
The World ◽  
Mortality Survey

Abstract Background The Central African Republic (CAR) suffers a protracted conflict and has the second lowest human development index in the world. Available mortality estimates vary and differ in methodology. We undertook a retrospective mortality study in the Ouaka prefecture to obtain reliable mortality data. Methods We conducted a population-based two-stage cluster survey from 9 March to 9 April, 2020 in Ouaka prefecture. We aimed to include 64 clusters of 12 households for a required sample size of 3636 persons. We assigned clusters to communes proportional to population size and then used systematic random sampling to identify cluster starting points from a dataset of buildings in each commune. In addition to the mortality survey questions, we included an open question on challenges faced by the household. Results We completed 50 clusters with 591 participating households including 4000 household members on the interview day. The median household size was 7 (interquartile range (IQR): 4—9). The median age was 12 (IQR: 5—27). The birth rate was 59.0/1000 population (95% confidence interval (95%-CI): 51.7—67.4). The crude and under-five mortality rates (CMR & U5MR) were 1.33 (95%-CI: 1.09—1.61) and 1.87 (95%-CI: 1.37–2.54) deaths/10,000 persons/day, respectively. The most common specified causes of death were malaria/fever (16.0%; 95%-CI: 11.0–22.7), violence (13.2%; 95%-CI: 6.3–25.5), diarrhoea/vomiting (10.6%; 95%-CI: 6.2–17.5), and respiratory infections (8.4%; 95%-CI: 4.6–14.8). The maternal mortality ratio (MMR) was 2525/100,000 live births (95%-CI: 825—5794). Challenges reported by households included health problems and access to healthcare, high number of deaths, lack of potable water, insufficient means of subsistence, food insecurity and violence. Conclusions The CMR, U5MR and MMR exceed previous estimates, and the CMR exceeds the humanitarian emergency threshold. Violence is a major threat to life, and to physical and mental wellbeing. Other causes of death speak to poor living conditions and poor access to healthcare and preventive measures, corroborated by the challenges reported by households. Many areas of CAR face similar challenges to Ouaka. If these results were generalisable across CAR, the country would suffer one of the highest mortality rates in the world, a reminder that the longstanding “silent crisis” continues.

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